Hospitals Turn To Spying On Doctors

[Guest guest]

Hospitals Turn To Spying On Doctors

 

CHICAGO, June 12, 2008

 

(AP) Lori Erickson-Trump has faked headaches and back pain. She's had

physicals and MRIs she didn't need and she gets paid for it - all to

evaluate the performance of doctors and their staffs.

 

Hospitals and health clinics are increasingly turning to these

undercover patients to grade the health care experience being

offered.

 

Now the ethics council of the American Medical Association is

pressing the doctors group to endorse such practices. AMA delegates

are expected to vote on the proposal, along with dozens of others,

during their five-day meeting beginning Saturday.

 

Some doctors are outraged at the idea.

 

Dr. Richard Frederick, of the University of Illinois College of

Medicine in Peoria, called it " official deceit " that could have

disastrous consequences. He wrote a commentary in May's edition of

Virtual Mentor, the AMA's online ethics journal.

 

" In some instances sham patients have presented to overcrowded

emergency rooms with chest pain, " he wrote. " How could the hospital

administration defend this exercise to someone who suffers an adverse

outcome while waiting his turn behind the person who is only

pretending to be sick? "

 

The proposal to the AMA does include restrictions that address that

and other concerns. The recommendation is to have a system that:

makes sure fake patients don't interfere with treating real ones;

gives doctors a heads-up that undercover patients might be visiting;

and ensures that bad reviews aren't used to punish doctors.

 

And Dr. James Loden, writing an opposing view in the online journal,

says undercover patients are neither " devious " nor " spying. "

 

" Employees, including doctors, are paid to do specific tasks; if they

choose to perform at a level that is less than acceptable, they need

to improve or find other jobs, " he wrote.

 

Loden, an ophthalmologist at Nashville, Tennessee-based Loden Vision

Centers, started using undercover patients to evaluate his business

two years ago.

 

The sham patients showed " that I consistently left the examining room

without asking clients whether they had any questions, " Loden wrote.

He also learned that some employees didn't always introduce

themselves or explain why tests were being performed.

 

The idea was to help the centers compete with others offering similar

services including Lasik surgery. The centers have worked to

eliminate the revealed shortcomings and Andy Patrick, Loden's chief

operating officer, said client-to-client referrals have since

increased.

 

" We don't always like what we hear, but it makes us get better and

better, " Patrick said.

 

Erickson-Trump, 37, works for Perception Strategies, an Indianapolis-

based company that provides undercover patients to health systems in

about 25 states. Her preferred job title is " mystery shopper, " a

service more familiar in the retail and food industries.

 

Brooke Billingsley, vice president of the company, said that when

asked to evaluate a doctor's skills, the firm often tries to use

undercover patients who really need a specific test, such as a

mammogram.

 

When a hospital wants its emergency room evaluated, Billingsley said

sometimes she'll schedule a fake patient with a real medical problem,

such as pneumonia symptoms.

 

Occasionally, undercover patients have been asked to undergo invasive

tests that reveal a surprise ailment, she said.

 

" Health care mystery shopping is so unique, " Billingsley said. " It's

just not like going and getting a Happy Meal. "

 

Erickson-Trump said one memorable " shop, " as she calls each job, was

to a dentist's office, where she had her teeth cleaned and X-rayed.

 

The receptionist offered her gourmet coffee and the dental chair had

a neck massage pillow, she recalled. " I was so surprised at the good

treatment ... that I ended up making them my permanent dentist. "

 

The MRI was also memorable " because it wasn't my favorite, " she said.

 

Erickson-Trump said she exaggerated some minor back pain for that

test, which requires patients to lie still inside a noisy cylindrical

scanner while internal images are made.

 

She had no complaints about the MRI technician, but the office

staffers didn't explain enough about what to expect.

 

" That's a very scary procedure " that can be claustrophobic, Erickson-

Trump said.

 

On other jobs, she's been asked to evaluate how well the doctor

listened, whether logical referrals were made, and how long she was

kept waiting. " You can show up and sit for hours on end sometimes,

and you're not sure why, " she said.

 

Henry Ford Health System spends $35,000 to $60,000 a year on

undercover patients to identify just that kind of problem at its

Detroit area clinics.

 

" Industry research shows that the patient perception of quality of

care is based upon their whole experience, " and not just on their

doctor's medical skills, said Henry Ford spokeswoman Rose Glenn.

 

Awards are given to staffers who get high scores, while education and

customer-service training is given to those who fare poorly, she

said.

 

 

 

© MMVIII The Associated Press

 

URL:http://www.cbsnews.com/stories/2008/06/12/health/main4177419.shtml